title: Acute kidney injury in patients with influenza A (H1N1) 2009.
abstract: OBJECTIVE
  We aim to evaluate the incidence and outcome of acute kidney injury (AKI) among critically ill adult patients with H1N1 2009 infection.
  
  
  METHODS
  From a prospectively collected influenza A (H1N1) 2009 bi-national, we identified 671 adult patients admitted to intensive care unit (ICU) from June 1 to August 31, 2009. Of these, 628 (93.6%) had admission and/or peak serum creatinine values during ICU stay. We defined AKI according to the creatinine criteria of the RIFLE classification.
  
  
  RESULTS
  Of 628 adult patients, 211 [33.6%, 95% confidence interval (CI) 29.8-37.4%] had AKI: 41 (6.5%) risk, 56 (8.9%) injury and 114 (18.2%) failure. Of all 211 AKI patients, 76 [36.0% (29.4-42.6%)] died in hospital (36.6% in risk, 25.0% in injury and 41.3% in failure group) compared with 33 of 408 (8.1%) patients without AKI. Among the 33 AKI patients treated with renal replacement therapy, 13 died (39.4%). Mechanical ventilation [odds ratio (OR) 3.62 (2.07-6.34)], any severe co-morbidity (OR 2.36, 95% CI 1.15-3.71), age (OR 1.02, 95% CI 1.01-1.03 per 1 year increase), and AKI (OR 6.69, 95% CI 4.25-10.55) were independently associated with hospital mortality.
  
  
  CONCLUSIONS
  Acute kidney injury appears common in H1N1 2009 infected patients and is independently associated with an increased risk of hospital mortality.
authors.affiliation: Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia. ville.pettila@hus.fi
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
authors.forename: Steven A R
authors.initials: SA
authors.lastname: Webb
authors.forename: Michael
authors.initials: M
authors.lastname: Bailey
authors.forename: Belinda
authors.initials: B
authors.lastname: Howe
authors.forename: Ian M
authors.initials: IM
authors.lastname: Seppelt
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000503:physiopathology; D000328:Adult; D001315:Australia / Q000453:epidemiology; D016001:Confidence Intervals; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index